Health Law

State & Federal Audits, Investigations & Litigation

Companies in the health care industry constantly face a gauntlet of intricate statutory and regulatory requirements. This close government scrutiny could trigger government audits and investigations of your company’s business practices, or even civil or criminal lawsuits.

Our Health Law attorneys regularly provide guidance on health care compliance issues, which allows us to offer creative and effective defenses and strategies in adversarial proceedings. We also have considerable experience representing companies that find themselves involved in civil and criminal cases in state and federal courts, and administrative tribunals. When needed, we assemble integrated, interdisciplinary teams to meet difficult litigation challenges your company might face. Our health care industry clients have enjoyed successes such as trial victories, pretrial dismissals, rejection or decertification of plaintiff classes, and advantageous settlements.

Of Counsel

Associate

Member

Representative Experience

Negotiated a $21 million settlement for a hospital client in a Medicare reimbursement appeal before the Provider Reimbursement Review Board.

Served as health care regulatory counsel to a hospital executive and his management company in a criminal cost report fraud case, United States v. Jones (5th Cir. Jan.16, 2007), and obtained reversal of the district court’s sentencing and restitution order based on weaknesses in the government’s case.

Successfully defended a for-profit hospital chain in a suit where the plaintiff sought to enjoin our client’s leveraged buyout.

Obtained a favorable resolution for a large retail pharmacy client involved in a government investigation into pharmacy reimbursement for generic pharmaceuticals.

Convinced the Accreditation Council for Graduate Medical Education and the Residency Review Committee to rescind its proposal to withdraw accreditation on an expedited basis and to restore the accreditation of a teaching hospital’s residency program.

Obtained a favorable resolution for a national, multisite anatomic pathology laboratory subject to a federal False Claims Act investigation that had arisen as a result of a qui tam case filed under seal by a relator against eight corporate defendants and 20 John Does.

ReutersOIG Issues New Guidance for Healthcare Companies on Excluded WorkersEllyn L. Sternfield
is quoted discussing the guidelines released by the U.S. Department of Health and Human Services for health care providers on how to avoid hiring workers who are banned from Medicare and Medicaid programs.

Modern HealthcareHeld Responsible: HHS Targeting Leadership for ViolationsHope S. Foster
is quoted discussing the record $3 billion GlaxoSmith-Kline(GSK) agreed to pay to resolve civil allegations and criminal charges regarding how it markets and discloses information on its pharmaceuticals.

Modern HealthcareThe Politics of FraudPaul E. Pelletier
is quoted discussing the Obama administration’s decision to publicize 107 Medicare fraud related arrests in one national announcement. Mr. Pelletier explains that these coordinated takedowns are intended to serve as a warning and to deter people from participating in healthcare fraud.

BNA’s Health Care Daily ReportFraud and Abuse: CMS Has Received $805,000 in Self-Referral Disclosure Settlements, Official SaysThomas S. Crane
is quoted discussing the importance of preparation when submitting to the Centers for Medicare & Medicaid Services under the self-referral disclosure protocol (SRDP).

12.08.2011

BNA's Health Care Daily ReportNo Sanctions for Proposed Online Referral Service for Health ProfessionalsThomas S. Crane
is quoted discussing the Department of Health and Human Services Office of Inspector General decision not to impose administrative sanctions or civil monetary penalties on a company that provides web-based services to physicians for a proposed plan to facilitate referrals between health professionals.

12.06.2011

BNA's Health Care Daily ReportU.S. Supreme Court Declines Review of Case on Liability for Causing False ClaimsThomas S. Crane
is quoted discussing the importance of the Supreme Court's decision in its implicit determination of the power of the FCA for policing violations of the myriad other laws and regulations under which providers operate.

10.31.2011

Medical Practice Compliance Alert Online Coupons May Violate Anti-Kickback RulesThomas S. Crane
is quoted discussing the potential risks associated with the use of websites like Groupon and Living Social in the medical community.

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